Study suggests oral screening a role for the dental team

Fiona Sandom, who is president of the British Association of Dental Therapists (BADT), has drawn our attention to a new study suggesting dental hygienists and therapists should be used to screen for dental caries and periodontal disease.

The report, with the rather forbidding title: The Efficacy of Screening for Common Dental Diseases by Hygiene-Therapists A Diagnostic Test Accuracy Study has important implications for skill mix, especially in NHS practice.

And the results have been welcomed by Fiona Sandom, who sees it as a major step towards a much more efficient use of the skill mix of the dental team.

Lead author, Richard Macey, research assistant at Manchester’s School of Dentistry, explained: ‘Researchers here at the School of Dentistry have been examining whether dental care professionals (DCPs) can screen for common oral disorders’.

What they found were comparable performances between hygienists or therapists and dentists, and demonstrated the former can screen for the two principle dental diseases.

Macey believes these findings, coupled with ‘direct access’, opens up the potential for a ‘much more comprehensive use of skill mix in the design and delivery of dental services’.

I have long believed that the future of NHS dentistry lies in the larger practice, with different healthcare professionals providing different services.

Dental hygienists were first trained by the RAF 70 years ago, but were not recognised by the General Dental Council (GDC) until 1970.

When I qualified 50 years ago, dental therapists were being trained at New Cross, but were not allowed to work in general practice until after I had retired 40 years later.

The Childsmile project in Scotland has shown that dental nurses, suitably trained, can deliver a preventive service as good, if not better, than that provided by dentists.

Isn’t it about time that dentists recognised the diverse skills and contributions of those in their teams?

Many do, but some don’t.

Let us also not forget the wise words of Adam Smith, printed on the back of (English) £20 notes, that division of labour results in increased productivity.

By using the skills of all the dental team, the larger practice can deliver ‘all treatment that is clinically necessary’ and do it to the same high standards as is required of them.

Michael Watson qualified 50 years ago and started his career in the Royal Army Dental Corps. Retiring in 1979 he set up a general dental practice in Manningtree. In the 80s he became secretary of the GDPA and was the first editor of its journal the General Dental Practitioner. Moving to the BDA in 1991 he spent the rest if his career as a political adviser and editing BDA news. Since retiring he has continued writing and is a regular contributor to dentistry.co.uk and Dentistry magazine along with being the news correspondent for both. Michael now spends more time at a time-share on Gran Canaria and reducing the kid’s inheritance on cruise ships.